Author Information

Kushal Dighe,

Waseem Sharieff,

Payam Dehghani,

Danny Marcuzzi,

Vikram Prabhudesai,

Tej Sheth,

Ian Billingsley,

Warren Ball and

Asim Cheema

Background

Current method of visual CT angiographic (CTA) analysis is hampered by high variability and poor reproducibility for detection of in-stent restenosis (ISR). In this report, we describe a new method of CTA analysis using contrast density gradient (CDG) and report its performance for ISR detection compared to gold standard quantitative coronary angiography (QCA).

Methods

Consenting patients undergoing invasive coronary angiography after LM stenting underwent 64 slice CTA (GE LightSpeed) within 30 days. Patients with renal insufficiency and significant arrhythmia were excluded. ISR was assessed by QCA and defined as ≥50% in-stent lumen narrowing. CDG was calculated as % difference between pre-stent contrast density and lowest of in-stent and post-stent density. ROC curves were used to choose cut off value that would maximize sensitivity and specificity. All measurements were completed in a blinded manner on per stent basis.

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